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Arrest of the Second Stage of Labor

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Arrest of the Second Stage of Labor

  • Definitions
  1. Arrest of Second Stage of Labor
    1. No descent or rotation after a fixed time interval or pushing
  2. Protracted Second Stage of Labor
    1. Slow rate of dilation and descent
    2. Nulliparous women
      1. Duration >3 hours (>4 hours with Epidural Anesthesia)
      2. Less than 25% of Nulliparous women will deliver vaginally after 3 hours of second stage
    3. Multiparous women
      1. Duration >2 hours (>3 hours with Epidural Anesthesia)
  • Management
  1. See Active Management of Labor
  2. Occiput Posterior position (or Occipitotransverse Position)
    1. See Manual Rotation in Occipitoposterior Presentation
  3. Consider assisted Vaginal Delivery